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The expression of blood group antigens A and/or B on the cornea was found to correlate directly with the blood group of the patients in all cases. The corneal epithelium of all 18 patients with blood groups A and/or B could be stained with antibodies to bga A and/or B. However, neither bga A nor bga B could be detected in any corneal cells of patients with the blood group O (21 patients). In addition to the epithelium, the stromal keratinocytes as well as the endothelium contained immunohistochemically detectable bga A and/or B in cases of keratitis or keratoconus, but not in stromal and/or endothelial cells of corneas with pseudophakic bullous keratopathy and Fuchs' dystrophy (all patients with the bgs A and/or B). CONCLUSION: These findings show that an up-regulation of bga A and/or B in corneal stromal and endothelial cells is possible in diseased corneas. This phenomenon might play an important role in graft rejection after corneal transplantation. (1)